Organization
KIDNEY LIFE, LLC
Active
Other names
Renal Center of Newark
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
571 CENTRAL AVE, NEWARK, NJ 07107-1463
(973) 484-4994
(973) 484-4434
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6410
(888) 662-8259
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0283100
—
NJ
Enumeration date
10/28/2008
Last updated
12/29/2020
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